Presented in part at the 18th ESICM Annual Congress – Amsterdam, 25–28 September 2005.
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Remifentanil for tracheal tube tolerance: a case control study†
Article first published online: 13 JUL 2007
DOI: 10.1111/j.1365-2044.2007.05100.x
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How to Cite
Machata, A. M., Illievich, U. M., Gustorff, B., Gonano, C., Fäßler, K. and Spiss, C. K. (2007), Remifentanil for tracheal tube tolerance: a case control study. Anaesthesia, 62: 796–801. doi: 10.1111/j.1365-2044.2007.05100.x
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Publication History
- Issue published online: 13 JUL 2007
- Article first published online: 13 JUL 2007
- Accepted: 17 March 2007
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Summary
We assessed the minimal remifentanil dosage required for tracheal tube tolerance in awake and spontaneously breathing patients after major abdominal surgery. Forty postoperative patients received remifentanil 0.1 μg.kg−1.min−1, which was reduced in steps of 0.025 μg.kg−1.min−1 every 30 min. Respiratory response subscore of comfort scale (CSRR), Ramsay sedation scale (RSS), visual analogue scale (VAS), respiratory rate, and minute ventilation were recorded. Spontaneous respiration with no or little response to ventilation (CSRR 2) in co-operative, oriented and tranquil patients (RSS 2) was defined as the main outcome and study endpoint. Thirty-one patients (77.5%) reached a CSRR 2 and RSS 2 with remifentanil 0.025 μg.kg−1.min−1 and nine patients (22.5%) required remifentanil 0.05 μg.kg−1.min−1. Analgesia was sufficient in all patients (VAS = 30). Remifentanil 0.025−0.05 μg.kg−1.min−1 achieves satisfactory tracheal tube tolerance in awake and spontaneously breathing patients.